| NPI | 1104454008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: UT 12407610-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MT 165424) |
| Enumeration Date | 2020-03-28 |
| Last Update Date | 2025-11-20 |